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Reminder: HHSC Does Not Cover Vaccines or Drugs That Do Not Have FDA Approval or Emergency Use Authorization

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

Texas Medicaid, the Children with Special Health Care Needs (CSHCN) Services Program, the Family Planning Program (FPP), and Healthy Texas Women (HTW) do not cover vaccines or drugs that are not authorized or approved by the U.S. Food and Drug Administration (FDA).

For information on COVID-19 vaccines and treatments currently authorized by the FDA, providers can visit the following pages on the Centers for Disease Control and Prevention (CDC) website:

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.